Merck Manual

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Cervical Cancer Screening and Prevention


Pedro T. Ramirez

, MD, Houston Methodist Hospital;

Gloria Salvo

, MD, MD Anderson Cancer Center

Reviewed/Revised Oct 2023

Screening tests

Cervical cancer screening effectively prevents cervical cancer and deaths from the disease.

Cervical cancer screening is recommended for everyone with a cervix starting at age 21 to 25 years. Screening tests are usually done every 3 to 5 years, depending on the person's age and the type of test.

Two types of tests are used to screen for cervical cancer:

  • HPV test: A sample from the cervix is tested to determine whether the HPV strains that cause most cervical cancers are present.

  • Pap test: Cells from the cervix are examined under a microscope to determine whether any are cancerous or abnormal. Abnormal cells may, without treatment, progress to cancer (these cells are called precancerous cells).

Screening may stop after age 65 years, but only if an adequate number of test results have been normal in the preceding 10 years.

If women have had a total hysterectomy (surgical removal of the uterus, including the cervix) and have not had cervical cancer or precancer, they do not need to have HPV or Pap tests.

The number of deaths due to cervical cancer has been reduced by more than 50% since Pap tests were introduced in countries where Pap tests are available.

If all women had cervical cancer tests as recommended, deaths due to this cancer could be virtually eliminated. However, in the United States, many women are not tested regularly, and in middle- and low-resource countries, cervical cancer screening is often not available.

Did You Know...

  • The number of deaths due to cervical cancer have decreased by more than 50% since Pap tests were introduced in countries where these tests are available.

  • If all women had HPV and/or Pap tests regularly, deaths due to this cancer could be virtually eliminated.

  • Getting vaccinated against HPV helps prevent cervical cancer.

HPV vaccine

The HPV vaccine Human Papillomavirus (HPV) Vaccine The human papillomavirus (HPV) vaccine helps protect against infection by the strains of HPV that are most likely to cause the following: Cervical cancer, vaginal cancer, and vulvar cancer in... read more provides immunity to the types of HPV that cause most cervical cancers (and genital warts and other cancers, including those of the anus, vagina, penis, throat, and esophagus). The vaccine can help prevent cervical and other cancers.

Being vaccinated before becoming sexually active is best, but people who are already sexually active should also be vaccinated.

Doctors recommend that vaccination in children at age 11 or 12 years, but children can be vaccinated as early as age 9 years.

For people under age 15 years, two doses of the vaccine are given 6 to 12 months apart.

For people aged 15 to 26 years, three doses of the vaccine are given. The first dose is followed by a dose 2 months later. The last dose is given 6 months after the first.


Using condoms Condoms Barrier contraceptives physically block the sperm’s access to a woman’s uterus. They include condoms, diaphragms, cervical caps, contraceptive gels, contraceptive sponges, and spermicides (foams... read more Condoms correctly during sexual intercourse can help prevent the spread of HPV. However, because condoms do not cover all the areas that can be infected and because HPV can be transmitted with external oral, genital, or anal contact, condoms do not fully protect against getting HPV.

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